Provider Demographics
NPI:1023043874
Name:DOW, CHARLES JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:JOSEPH
Last Name:DOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:125 PARKER HILL AVENUE
Mailing Address - Street 2:FOGG 430
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2847
Mailing Address - Country:US
Mailing Address - Phone:617-264-4500
Mailing Address - Fax:617-232-4153
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:FOGG 430
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-2847
Practice Address - Country:US
Practice Address - Phone:617-264-4500
Practice Address - Fax:617-232-4153
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2009-04-10
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Provider Licenses
StateLicense IDTaxonomies
MA77999207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00426745OtherMEDICARE RAILROAD
MA0014371OtherNEIGHBORHOOD HEALTH PLAN
MA304011OtherHARVARD PILGRIM
MAB20498801OtherCIGNA
MAJ30900OtherBLUE CROSS / BLUE SHIELD
MA795212OtherTUFTS
MA795212OtherSECURE HORIZON
MA25-00469OtherUNITED HEALTHCARE
MA304011OtherFIRST SENIORITY
MA0099832OtherAETNA
MA28771OtherFALLON
MA3130789Medicaid
MAB20498801OtherCIGNA
E52739Medicare UPIN